Not sure whether to use the ‘insufficiency’ or ‘other’ code for incompetence NOS? Here’s the answer.
ICD-10 is ousting the simplicity of a single code for nonrheumatic mitral valve disorders. Check out the five new options you’ll need to know.
424.0, Mitral valve disorders
Question: Our surgeon removed a mass from a patient’s nose (1.3 cm, including margins), and the pathologist diagnosed it as a dermoid cyst. Should we report 11442 for the service?
CMS now provides coverage for these tests in certain populations.
After several months of wrangling, CMS has confirmed that it will pay for hepatitis C virus screenings administered to Medicare patients who meet specific criteria. The agency also debuted a new HCPCS code to describe the preventive test and offered diagnosis coding tips, all thanks to Transmittal 174, issued on Sept. 5.
The specifics: Effective for dates of service June 2, 2014 and afterward, CMS will pay for hepatitis C screenings if patients meet either of the following two requirements:
Check with your payer before you report endoscopic procedure.
You won’t find it too challenging to report epidural adhesiolysis if you know how to construe the operative note to confirm what your physician did. Here is how you can flawlessly report this procedure and earn your deserved payment.
1. Do Not Limit Yourself to One Day
Your surgeon may continue the procedure of adhesiolysis over a period of time. Carefully read through the operative note to determine the number of days the catheter remains in the anatomical location. You will choose the right code depending upon how many days the procedure was done. Accordingly,
The September 2014 CPT® Assistant is brimming with recent coding updates and coding tips for deciding when to report fluoroscopy separately. Find out how the CPT® 2015 code set will impact bundling of intrathecal contrast administration via lumbar injection and myelographic radiologic S & I. The issue also briefs you on how to append modifier 59 to computed tomography of the spine with contrast if the provider performs CT subsequent to a myelogram on the same patient the same day.
Reviewing the latest issue will also improve your understanding of how to report an anogenital examination. To get spot-on guidance, simply type a code or keyword into SuperCoder.com’sCode Connect to see the September article that suits your needs:
- Anogenital Examination: 99170
- Fluoroscopy Codes: 76000, 76001, 71023, 71034, 36597, 64581, 49440, 49441, 49442, 49446, 49450, 49451, 49452, 49460, 49465, 64561
- ICD-10-CM “Z” Codes
- Myelography and Injection Procedure Codes : 72240, 72255, 72265, 72270, 62284, 62270, 61055, 72126, 72129, 72132
The latest selection of CPT® Assistant FAQs also provides guidance for a variety of areas. Find authoritative answers in a snap by looking for these codes and topics on Code Connect:
Review guidelines on how to code when the diagnosis isn’t definite.
Implementation of ICD-10 may have been deferred to October 2015, but the Centers for Medicare & Medicaid Services (CMS) has stepped up guidance to help you prepare for the new diagnosis coding system. Recently the agency released a transmittal that should help you understand how you’ll report these codes when insurers start requiring them next year.
CMS issued Transmittal 3020 on Aug. 8, and it announces revisions to the official ICD-10 Coding Guidelines which put them more in line with the current ICD-9 rules. For example, CMS revised the ICD-10 regs to now say, “Do not code diagnoses documented as ‘probable,’ ‘suspected,’ ‘questionable,’ ‘rule out,’ or ‘working diagnosis’ or other similar terms indicating uncertainty. Rather, code the condition(s) to the highest degree of certainty for that encounter/visit, such as symptoms, signs, abnormal test results, or other reason for the visit.”
Question: We’re getting denials when we bill a blood glucose test with 82962. The payer says that the test isn’t payable under contractual agreement. Is this the correct code?
Don’t forget the ‘Five A’ strategy in your documentation.
When CMS established code G0447 in 2011, Part B practices were thrilled to have a way to report obesity counseling. However, in the three years that have passed since the code debuted, several issues have cropped up that plague these claims—and you should know what they are if you want to collect for your services.
Background: You can report G0447 (Face-to-face behavioral counseling for obesity, 15 minutes) if your patient has a body mass index (BMI) of 30 kg/m2 or higher and you perform obesity counseling. Medicare will reimburse you for one visit per week for the first month and one visit every other week between months two and six. In addition, if the patient loses 6.6 pounds during the first six months, he is eligible for an additional visit every month for months seven through 12.
Focus on Physician Records
Documentation of your provider’s role is crucial.
Postoperative pain control is a standard part of care for some patients, such as those who have arthroscopic shoulder surgery. Being reimbursed for your pain management specialist’s service isn’t automatic, however, so remember some key points before submitting a separate claim for the injection or catheter placement.
1. The injection or catheter placement must be administered by a different physician than the surgeon who performed the surgery. You won’t have any problem meeting this criterion, but it’s still good to be aware of the guidelines.
2. Your provider should complete a separate procedure report for the post-op pain management procedure.
You’ll need more info in 2015.
When your pathologist diagnoses an adenomatous polyp submitted from a colonoscopy, you’ll need to know much more information to choose the proper ICD-10 code.
Make sure you train your pathologists to document the proper details so you can properly code these cases when ICD-10 goes into effect on Oct. 1, 2015.
From One to Many
You just need one code for adenomatous colon polyp under ICD-9: 211.3 (Benign neoplasm of colon).